The Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Demonstration Project Commences November 1, 2007
The Centers for Medicare & Medicaid Services (CMS) has instructed the National Supplier Clearinghouse (NSC) to begin the DMEPOS demonstration project on November 1, 2007. This demonstration project will involve all DMEPOS suppliers located in the following counties:
- South Florida: Miami-Dade, Broward and Palm Beach
- Southern California: Los Angeles, Orange, Riverside and San Bernardino
There are three major components to this demonstration:
1. Immediate submission of CMS 855S application - Each DMEPOS supplier in the demonstration locales will be required to submit a CMS 855S Medicare enrollment application to the NSC within 30 days after the NSC requests such data. The NSC will notify suppliers by letter to submit the CMS 855S. The letter will contain instructions and indicate a date by which the form must be received by the NSC. If the form is not received timely, the suppliers billing privileges will be revoked. Also, no extensions will be granted. The NSC will begin mailing these letters on October 31, 2007.
Note: In order to properly administer this project, please do not submit a CMS 855S reenrollment application until notified to do so by the NSC.
2. Revocation of billing privileges - Under this demonstration, a DMEPOS supplier's Medicare billing privileges will be revoked in the following circumstances:
- The DMEPOS supplier failed to submit a CMS 855S application within the aforementioned 30-day timeframe
- The DMEPOS supplier failed to report a change in ownership or address at least 30 days prior to the effective date of the change
- The DMEPOS supplier failed to obtain accreditation from an approved DMEPOS accrediting organization within 120 days of notification from the NSC to do so
Note: Not every DMEPOS supplier will be required to obtain accreditation under this demonstration. Only those that are notified by the NSC to become accredited will be subject to that requirement.
- The DMEPOS supplier has an owner or managing employee that has had a felony conviction within the last 10 years
- The DMEPOS supplier no longer meets each and every requirement necessary for enrollment as a DMEPOS supplier
If the supplier's billing privileges are revoked, CMS will implement recoupment measures as appropriate.
3. Enhanced review of 'remaining' DMEPOS suppliers - DMEPOS suppliers that do not have their Medicare billing privileges revoked based on the information contained in the CMS 855S application they submitted will be subject to an enhanced review.
This may include additional unannounced site visits and targeted claims reviews.
For Additional Information
Visit the CMS Web site and click on the 'Enrollment Demonstrations' link on the left-hand side of the page.
To review notices, alerts and bulletins, please visit www.cms.hhs.gov/medlearn.